Healthcare Provider Details

I. General information

NPI: 1144177957
Provider Name (Legal Business Name): CHRISTOPHER M SOTO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 S EUCLID AVE
SAINT LOUIS MO
63110-1010
US

IV. Provider business mailing address

4910 W PINE BLVD APT 314
SAINT LOUIS MO
63108-1987
US

V. Phone/Fax

Practice location:
  • Phone: 233-593-3492
  • Fax:
Mailing address:
  • Phone: 233-593-3492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: